Essays, talks, press, and podcast episodes on value-based care, healthcare entrepreneurship, and building systems that actually reach people.
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A conversation on healthcare access, workforce resilience, and health equity in the Inland Empire. Hosted by AltaMed Health Services, the inaugural summit brought together healthcare leaders, elected officials, employers, educators, and community stakeholders to build a healthier, more connected region.
"I was born in Iran and came to the U.S. as a refugee in September 1998… That thread runs through everything I've built since." A full-length profile on the origin story behind Carenodes, seven years of bootstrapped growth, and why healthcare's biggest failures are administrative, not clinical.
Invited to present on payer-provider strategy and value-based contracting at the HBMA Annual Conference. 600+ provider organizations contracted across every major payer class — the frameworks, the failures, and what actually works.
The structural misalignments that doom payer-provider arrangements in the first 90 days — and the three things that separate contracts that hold from ones that collapse under the weight of their own complexity.
Remarks delivered upon receiving the Outstanding Leadership Award at the Health 2.0 National Conference. On building companies that serve populations the industry has historically ignored.
Eight years. All 50 states. 134 providers. The operational, financial, and human lessons from building a digital healthcare company from zero to national scale — including the things I would do differently.
Featured in Becker's Hospital Review on the structural shifts reshaping payer-provider relationships — and why the organizations that adapt their contracting infrastructure now will define the next decade of value-based care.
A detailed account of structuring one of the largest maternal health value-based agreements in California — the negotiation dynamics, the clinical model, and the lessons that apply far beyond maternal health.
The full recording of Alex's HBMA continuing-education webinar. Five payer-contract provisions that generate the most downstream billing failures, a three-phase audit framework for finding them, and a denial-routing model that keeps contract-based underpayments from being silently written off.
17 minutes. That's how long Lindsay Clancy's last psychiatric visit lasted — the day before her three children died. Nine prescribers. Two hospitals. A suicide hotline called twice. Alex and Jasmine Singh examine the care coordination failure hiding inside the civil complaint.
A pediatric patient is medically ready for discharge — equipment arranged, nursing hours authorized. The only missing piece: an actual nurse. This episode examines the structural gap between authorized private duty nursing hours and filled hours in Medicaid managed care.
Persistent underpayment, denials that don't respond to appeals, patterns nobody can explain — these are often contract problems wearing a billing problem's disguise. Alex breaks down the structural gap between contracting and RCM that costs providers real money every day.
A regional Medicaid managed care plan wants to talk contracting. The fee schedule is fine — not great, fine. Alex breaks down the payer contracting decision as what it actually is: a market entry and operational alignment commitment that happens to include a rate negotiation inside it.
CMS's LEAD model replaces ACO REACH in 2027. Most ACO applications fail before they're submitted — not because organizations are ineligible, but because they were never really built for risk. Alex breaks down the six scoring domains CMS will use to evaluate your application.
Rate sheets don't tell the whole story. Alex breaks down the 8-indicator playbook he uses to evaluate any tele-behavioral health market before committing capital — and names the specific states he'd enter today and why.
Why are employers often paying two to four times Medicare rates for identical procedures? Alex sits down with Dr. Kumar Dharmarajan — co-founder and CMO of World Class Health and former CMO at Clover Health — to unpack the structural difference: incentive alignment.
CMS is moving tens of billions of dollars into every state to stabilize rural healthcare — not through across-the-board rate increases, but through targeted investments in workforce, technology, care coordination, and alternative payment models.
Payers are quietly narrowing networks and rewriting delegation expectations. Alex breaks down what's actually showing up in payer conversations right now — why waiting for regulatory clarity is already costing providers leverage.
A federal jury convicted the founders of Done for orchestrating one of the largest Adderall distribution and fraud schemes in U.S. history. Alex breaks down what this case means for the entire digital health ecosystem and why value-based care is the antidote.
Medicare's 2026 physician fee schedule is packed with change — shorter billable windows for remote monitoring, new behavioral health add-ons, incentives for value-based care, expanded digital therapeutics reimbursement, and a major shift from inpatient to outpatient.
A 5% increase in Medicare payment rates, the scaling back of supplemental benefits, permanent telehealth for behavioral health, and the transition to a new risk adjustment model. Alex breaks down what it takes to thrive in the evolving Medicare Advantage landscape.
The often overlooked aspect of leadership: emotional labor. Alex shares personal experiences on how managing emotions plays a pivotal role in negotiations — and how emotional labor can be both a powerful tool and a silent tax on leaders challenging dominant norms.
Mindfulness meditation and its profound implications for healthcare leadership. The neurological benefits, cognitive flexibility, and practical techniques that can be integrated into the daily routines of healthcare professionals.
How health tech startups can win at managed care contracting. Understanding managed care mechanics, value-based care vs. fee-for-service, contracting tips for Series A and B stage startups, risk corridors, capitation, and how to speak the payer language.
The historical context of childbirth, the current state of maternal mortality in the U.S., and the emerging role of doulas in modern maternity care. How doulas can improve outcomes and reduce costs — and how to strategically leverage the doula opportunity in risk-based contracting.
How companies like CVS Caremark and pharmaceutical giants manipulate the system to maximize profits. Medicare Advantage plans cherry-picking healthier patients. The hidden influence of consulting firms like McKinsey. And why the system often feels rigged against everyday citizens.
The health insurance industry faces a perfect storm: rising costs, increased patient demand, and intense scrutiny from lawmakers. Medicare Advantage plans once considered the crown jewel of insurer profitability are under pressure. Where are the opportunities for providers and entrepreneurs?
Hidden fees, surprise bills, and the alleged cartel controlling out-of-network reimbursements. Alex breaks down the AMA's antitrust lawsuit accusing MultiPlan of working with UnitedHealthcare, Cigna, and Aetna to suppress out-of-network payments — costing providers $19 billion annually.
The rising tide of healthcare startups pursuing value-based care with ambitious visions — but without a robust patient acquisition strategy. Alex addresses the pain points and offers actionable advice for navigating the competitive healthcare market.
Alex and Dr. Chris Esguerra — former Senior Medical Director at Blue Shield of California and Deputy CMO at Health Plan of San Mateo — discuss the complexities of mental health parity, the challenges providers face navigating insurance plans, and how employers can advocate for better coverage.
How shifting population demographics are reshaping the value-based care landscape — and what providers and payers need to understand to stay ahead of the curve.
The system used to pay for healthcare today does not encourage the integration of health care and social care. New financing approaches are needed to enable the health care sector to engage in activities that strengthen social care and community resources.
No two states are alike in how telehealth is defined and regulated. A comprehensive overview of telehealth policy across all 50 states and DC — reimbursement rules, controlled substance prescribing, audio-only services, and the post-COVID regulatory landscape.
Florida's 2019 telehealth law establishes standards of practice for telehealth services, including patient evaluations, record-keeping, and controlled substances prescribing. What providers need to know about the rules governing out-of-state practitioners and Medicaid reimbursement.
California Governor Gavin Newsom signed Senate Bill 855 into law, increasing health and disability insurers' coverage obligations for mental health and addiction diagnosis, prevention, and treatment. What this means for providers navigating payer conversations.
No cadence. No filler. Just the pieces worth your time — on value-based care, healthcare entrepreneurship, and building things that last.
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